scholarly journals Relationship between red cell distribution width and prognosis in patients with breast cancer after operation: a retrospective cohort study

2019 ◽  
Vol 39 (7) ◽  
Author(s):  
Deshun Yao ◽  
Zhiwu Wang ◽  
Haifeng Cai ◽  
Ying Li ◽  
Baosheng Li

Abstract We retrospectively enrolled 825 breast cancer patients, who was primarily diagnosed in our hospital between January 2009 and December 2014 and explored the relationship between red blood cell distribution width (RDW) and long-term prognosis in patients with breast cancer. There were 412 patients with high RDW (RDW > 13.82) and 413 patients with low RDW (RDW ≤ 13.82). Compared with low RDW group, the high w group has large tumor size (the rate of tumor size >2 cm: 60.7 vs 44.8%, P=0.013). The rate of lymph node metastases was higher in the high RDW group thaten that in the low RDW group (62.1 vs 45.8%, P=0.000). RDW was positively associated with tumor stage. The high RDW tended to be advanced stage (P=0.000). Compared with low RDW group, the high RDW group tended to be higher lymphocyte count (P=0.004), elevated fibrinogen (P=0.043), and elevated high-sensitivity C-reactive protein (P=0.000). The Kaplan–Meier analysis indicated elevated RDW was positively associated with disease-free survival (DFS) (P=0.004) and overall survival (OS) (P=0.011). The multivariate Cox regression analysis indicated that the high RDW group had poorer OS (Hazard risk [HR] = 2.43; 95% CI: 1.62–3.21; P=0.024) and DFS (HR = 1.89; 95% CI: 1.28–3.62; P=0.000) compared with low RDW group. The present study found that high pretreatment RDW levels in breast cancer patients were associated with poor OS and DFS. RDW could be a potential predictive factor in differential diagnosis of poor prognosis from all patients.

2021 ◽  
Vol 16 ◽  
Author(s):  
Dongqing Su ◽  
Qianzi Lu ◽  
Yi Pan ◽  
Yao Yu ◽  
Shiyuan Wang ◽  
...  

Background: Breast cancer has plagued women for many years and caused many deaths around the world. Method: In this study, based on the weighted correlation network analysis, univariate Cox regression analysis and least absolute shrinkage and selection operator, 12 immune-related genes were selected to construct the risk score for breast cancer patients. The multivariable Cox regression analysis, gene set enrichment analysis and nomogram were also conducted in this study. Results: Good results were obtained in the survival analysis, enrichment analysis, multivariable Cox regression analysis and immune-related feature analysis. When the risk score model was applied in 22 breast cancer cohorts, the univariate Cox regression analysis demonstrated that the risk score model was significantly associated with overall survival in most of the breast cancer cohorts. Conclusion: Based on these results, we could conclude that the proposed risk score model may be a promising method, and may improve the treatment stratification of breast cancer patients in the future work.


2018 ◽  
Vol 49 (3) ◽  
pp. 961-970 ◽  
Author(s):  
Peng Xing ◽  
Huiting Dong ◽  
Qun Liu ◽  
Tingting Zhao ◽  
Fan Yao ◽  
...  

Background/Aims: This study aimed to explore the prognostic value of aldehyde dehydrogenase 1 (ALDH1) expression and vasculogenic mimicry (VM) in patients with breast cancer. Methods: ALDH1 expression and the presence of VM were examined by immunohistochemistry and CD31/PAS double staining, respectively, using formalin-fixed paraffin-embedded tissues from 202 breast cancer patients. The mean follow-up period ranged from 15 to 115 months. The Kaplan-Meier method was used to plot survival curves. Prognostic values were assessed by multivariate analysis using the Cox regression model. Results: ALDH1 expression was strongly associated with VM (P = 0.005). ALDH1 expression was positively correlated with histological grade (P = 0.011). Both ALDH1 expression and VM were negatively related to the status of the estrogen receptor and progesterone receptor and were statistically increased in triple-negative breast cancer. Patients with ALDH1 expression or VM displayed poorer disease-free survival (DFS) and overall survival (OS) than ALDH1-negative or VM-negative patients, with the worst OS and DFS observed in ALDH1/VM-double-positive patients. ALDH1-positive and VM-positive were independent survival risk factors for DFS and OS. Conclusion: ALDH1 expression and VM are correlated with the survival rate of patients with breast cancer. ALDH1 and VM, either alone or together, are prognostic factors in patients with breast cancer.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 596-596
Author(s):  
P. P. Gor ◽  
R. J. Gray ◽  
M. Horn ◽  
T. R. Rebbeck ◽  
P. A. Gimotty ◽  
...  

596 Background: Disparate outcomes of breast cancer patients after adjuvant chemotherapy may be influenced by variation in drug metabolism due to genetic polymorphisms in DME. Cyclophosphamide and thiotepa require activation by cytochrome P450 (CYP) and detoxification by glutathione-S-transferase, two highly polymorphic enzymes. We hypothesized that variants in CYP3A4(*1B), GSTM1 and GSTT1 would impact survival outcomes after adjuvant chemotherapy, with effects potentially modulated by chemotherapy dose. Methods: We performed a retrospective cohort study of patients enrolled on E2190/Int0121, a randomized trial of cyclophosphamide (C), doxorubicin (A), and fluorouracil (F) versus CAF + high dose chemotherapy (HDC) using cyclophosphamide and thiotepa followed by stem cell rescue; disease-free survival (DFS) and overall survival (OS) were equivalent in the clinical trial. PCR-based methods were used to genotype hematologic stem cells. Hazard ratios for genotypes were obtained using Cox regression. Results: Stem cell samples and clinical data from August 1, 1991 through August 1, 2005 were available for 347/540 of patients enrolled; 151 patients on CAF and 196 on CAF + HDC arms, respectively. Median follow-up was 9.8 years. See table . CYP3A4*1B allele carriers had significantly poorer DFS (HR 1.84) in the combined cohort and CAF arm (HR 1.87), but not in the HDC arm; OS was not significant by CYP3A4 genotype. GSTM1 null homozygotes in the combined cohort and HDC arm had significantly better DFS (HR 0.70 and 0.66, respectively) and OS (HR 0.67 and 0.57, respectively), but not in the CAF arm. GSTT1 null homozygotes had significantly worse DFS (HR 2.3) and OS (2.02) in the CAF arm, but not in the HDC arm or combined cohort. Conclusions: In the overall E2190/Int0121 cohort, polymorphisms in activating (CYP3A4*1B) and inactivating (GSTM1) DME significantly impact DFS and OS. The detrimental effect of GSTT1 in the CAF arm appears to be ameliorated by HDC. [Table: see text] No significant financial relationships to disclose.


2022 ◽  
Author(s):  
Meng Luo ◽  
Huihui Chen ◽  
Hao Deng ◽  
Yao Jin ◽  
Gui Wang ◽  
...  

Abstract PurposePostmastectomy radiotherapy (PMRT) after NAC in breast cancer patients with initial clinical stage cT1−2N+, especially for those who achieved ypT1−2N0, is still controversial. This study was to evaluate the survival prognosis of cT1−2N+ patients after NAC with or without PMRT, and to discuss the selection of patients who may omit PMRT.Patients and MethodsFrom January 2005 to December 2017, 3055 female breast cancer patients underwent mastectomy in our medical center, among whom 215 patients of cT1−2N+ stage, receiving neoadjuvant chemotherapy (NAC) with or without PMRT were finally analyzed. The median follow-up duration was 72.6 months. The primary endpoint was overall survival, and the secondary endpoint was disease-free survival. Comparison was conducted between PMRT and non-PMRT subgroups.ResultsOf the 215 eligible patients, 35.8% (77/215) cT1−2N+ patients achieved ypT0−2N0 after NAC while 64.2% (138/215) of the patients remained nodal positive (ypT0−2N+). The 5-year DFS of ypT0−2N0 non-PMRT was 79.5% (95% confidence interval [CI] 63.4-95.6%). No statistically significant difference was observed between the ypT0−2N0 PMRT and non-PMRT subgroups for the 5-year DFS (78.5% vs 79.5%, p = 0.673) and OS (88.8% vs 90.8%, p = 0.721). The 5-years DFS didn’t obviously differ between the ypT0−2N0 non-PMRT subgroup and cT1−2N0 subgroup (79.5% vs 93.3%, p = 0.070). By using Cox regression model in multivariate analyses of prognosis in ypT0−2N+ PMRT subgroup, HER2 overexpression and triple-negative breast cancer were significantly poor predictors of DFS and OS, while ypN stage was significant independent predictors of OS.ConclusionAn excellent response to NAC (ypT0−2N0) indicates a sufficiently favorable prognosis, and PMRT might be omitted for cT1−2N+ breast cancer patients with ypT0−2N0 after NAC.


2022 ◽  
Vol 10 ◽  
pp. 205031212110678
Author(s):  
Mwendwa Dickson Wambua ◽  
Amsalu Degu ◽  
Gobezie T Tegegne

Objectives: Despite breast cancer treatment outcomes being relatively poor or heterogeneous among breast cancer patients, there was a paucity of data in the African settings, especially in Kenya. Hence, this study aimed to determine treatment outcomes among breast cancer patients at Kitui Referral Hospital. Methods: A hospital-based retrospective cohort study design was conducted among adult patients with breast cancer. All eligible breast cancer patients undergoing treatment from January 2015 to June 2020 in the study setting were included. Hence, a total of 116 breast cancer patients’ medical records were involved in the study. Patients’ medical records were retrospectively reviewed using a predesigned data abstraction tool. The data were entered, cleaned, and analyzed using SPSS (Statistical Package for Social Sciences) version 26 software. Descriptive analysis—such as percentage, frequency, mean, and figures—was used to present the data. Kaplan–Meier survival analysis was used to estimate the mean survival estimate across different variables. A Cox regression analysis was employed to determine factors associated with mortality. Results: The study showed that the overall survival and mortality rate was 62.9% (73) and 37.1% (43), respectively. The regression analysis showed that patients who had an advanced stage of disease had a 3.82 times risk of dying (crude hazard ratio= 3.82, 95% confidence interval = 1.5–9.8) than an early stage of the disease. Besides, patients with distant metastasis had 4.4 times more hazards of dying than (crude hazard ratio = 4.4, 95% confidence interval = 2.1–9.4) their counterparts. Conclusion: The treatment outcome of breast cancer patients was poor, and its overall mortality among breast cancer patients was higher in the study setting. In the multivariate Cox regression analysis, the tumor size was the only statistically significant predictor of mortality among breast cancer patients. Stakeholders at each stage should, therefore, prepare a relevant strategy to improve treatment outcomes.


2020 ◽  
Author(s):  
Xiao Li ◽  
Xiaoli Zhang ◽  
Shen Yin Zhong ◽  
Jie Liu

Abstract Background: Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively.Results: A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at five years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), liver metastases (HR=2.085), and brain metastases (HR=1.903) were independent risk factors for prognosis; married status (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95% CI: 0.485-0.992), but the interaction between race and subtype did not reach significance for prognosis.Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.


2020 ◽  
Author(s):  
Jie Li ◽  
Yuan-Yi Rui ◽  
Bo Song ◽  
Ke Zhang ◽  
Bo Yi ◽  
...  

Abstract Background: The aim of this study was to find that if the red cell distribution width (RDW) or hemoglobin (Hb) level variations had prognostic value in stage III colorectal cancer patients treated with operation and adjuvant chemotherapy. Methods: One hundred and twenty-two patients were included in this retrospective study. All were diagnosed and re-staged as stage III colorectal cancer in Sichuan Cancer Hospital according to the AJCC Cancer Staging Manual, 8 th edition, 2018. The patients received R0 resection before adjuvant chemotherapy. The baseline information, routine blood examination data, pathological outcome and prognostic stature was retracted from the database. Receiver operating characteristic (ROC) curve analysis was utilized to determine the cut-off value, while the survival analyses were performed with Kaplan-Meier curve, the log-rank test and the Cox regression analysis. Results: The chemotherapy-associated hemoglobin change (change between the pre- and post-chemotherapy hemoglobin levels) was identified to be associated with the metastasis (P=0.030). The optimal cut-off point was calculated to be -9.5 by the ROC curve of the hemoglobin change, while the area under the curve was 0.648 (95% CI: 0.524-0.772). The results showed that patients with larger hemoglobin decrease had significantly worse disease free survival (DFS) than those with smaller decrease (P=0.020). Factors associated with DFS in uni-variate COX regression analysis were the number of harvested lymph nodes (P=0.040) and the perineural invasion (P=0.020). The peri-chemotherapy change of hemoglobin level was estimated to have significant effect on patient survival (P=0.010). Conclusions: We concluded that chemotherapy-associated Hb change (change between the pre- and post-chemotherapy) was a DFS prognostic factor for the stage III colorectal cancer patients who underwent operation and adjuvant chemotherapy.


Breast cancer is the most common cancer in women, and the major cause of death. This study was conducted in order to make a descriptive study and survival analysis for breast cancer patients in Mosul. Two hundred forty-six early diagnosed women with breast cancer out of 290 patients were included during the period from March 2007 to February 2012. The average follows up was 36. months (range: 11-67 months). The patients were undergone modified radical removal of the breast, chemotherapy and deep radiation. Patients with estrogen positive were given tamoxifen for five years. Patients with Her2/neu positive were given trastuzumab with docytaxil for one year. Only 25 patients (10.2%) died during the study. The highest incidence of breast cancer (35.8%) was between the ages 51 ≥ 60 years. The presentation of cancer was high (90.1%) in the lumber. Tumor in the right side (66.35%) was significantly higher than the left side. Metastasis was high (25%) and most of them in the liver (19.1%). The percentage of patients with positive estrogen, progesterone, and Her2/neu receptors were not different from negative receptors. Cox regression analysis showed that metastasis had significant effect on death (hazard ratio=2.917). Age 31 ≥ 40 years was the least affected age (hazard ratio=0.034). In conclusion, survival rate of breast cancer patients in Mosul is high due to good management. The early detection of cancer is the best way for survival of the patients, by developing the educational programs.


2020 ◽  
Author(s):  
Yiqun Han ◽  
Jiayu Wang ◽  
Binghe Xu

Abstract To better understand the heterogeneity of tumor microenvironment (TME) and establish a prognostic model for breast cancer in clinical practice, the leukocyte infiltrations of 22 cell types of interest from 2620 breast cancer patients were quantitatively estimated using deconvolution algorithms, and three TME subtypes with distinct molecular and clinical features were identified by unsupervised clustering approach. Then, we carried out systematic analyses to illustrate the contributing mechanisms for differential phenotypes, which suggested that the divergences were distinguished by cell cycle dysfunction, variation of cytotoxic T lymphocytes activity. Next, through dimensionally reduction and selection based on random-forest analysis, least absolute shrinkage and selection operator (LASSO) analysis, and uni- and multivariate COX regression analysis, a total of 15 significant genes were proposed to construct the prognostic immune-related score (pIRS) system and, in combinations with clinicopathological characteristics, a predictive model was ultimately built with well performance for survival of breast cancer patients. Comparative analyses demonstrated that proactivity of CD8 T lymphocytes and hyper-angiogenesis could be attributed to distinct prognostic outcomes. In conclusion, we retrieved three TME phenotypes and the curated prognostic model based on pIRS system for breast cancer. This model is justified for validation and optimized in the coming future.


2020 ◽  
Author(s):  
Jie Zhang ◽  
Sujie Zhang ◽  
Xiaoyan Li ◽  
Fan Zhang ◽  
Lei Zhao

Abstract Background: Breast cancer is the most common cancer among women in the world. NKX6.1 is proved to be involved in several human cancers, but fewer researches have reported the functional roles of NKX6.1 in breast cancer. In this study, we investigated the clinical significance of NKX6.1 expression in breast cancer prognosis.Methods: The expression level of NKX6.1 in breast cancer tissues and paired non-cancerous tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Chi-square test was applied to evaluate the relationship between NKX6.1 expression and clinicopathologic parameters. The overall survival of breast cancer patients were analyzed by Kaplan-Meier method with log rank test. Additionally, cox regression analysis was used for prognosis analysis.Results: NKX6.1 expression level is increased in breast cancer tissues (P<0.001). Moreover, the elevated levels were significantly correlated with tumor size (P=0.002), TNM stage (P=0.018) and lymph node metastasis (P=0.007). In addition, breast cancer patients with high NKX6.1 level had a poorer overall survival than those with low level (log rank test, P=0.001). NKX6.1 was an independent prognostic factor for breast cancer (HR=2.961, 95%CI=1.368-6.411, P=0.006).Conclusions: NKX6.1 is up-regulated in breast cancer, which may be a potential prognostic biomarker for the cancer.


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